Zhao Chenyang, Chen Fei, Li Qiong, Tan Chen, Zhang Wei, Peng Lixiu, Yue Chaoyan
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Obstetrics and Gynecology, The First People's Hospital of Chenzhou, Chenzhou, China.
Medicine (Baltimore). 2024 Nov 22;103(47):e40616. doi: 10.1097/MD.0000000000040616.
Consensus remains elusive regarding the relationship between C-reactive protein (CRP) levels and endometrial cancer (EC). Our study sought to elucidate the causal association between CRP and EC, aiming to contribute to the understanding of this complex interplay. We primarily utilized the random-effects inverse variance-weighted method. This approach served as the foundation for our analysis, complemented by 3 additional techniques, including Mendelian randomization-Egger, weighted-median, and weighted mode. A series of sensitivity analyses were also conducted to affirm the stability and reliability of our results. Employing the inverse variance-weighted method, our findings indicated that a one-unit increment in log-transformed CRP concentrations (mg/L) was associated with a relatively 9.7% increased risk of overall EC (odds ratio [OR] = 1.097, 95% confidence interval [CI]: 0.996-1.208, P = .061), an 11% higher risk of endometrioid endometrial cancer (OR = 1.110, 95% CI: 1.000-1.231, P = .049) and a 25% increased risk of non-endometrioid cancers (OR = 1.250, 95% CI: 1.005-1.555, P = .045). Sensitivity analyses did not reveal evidence of horizontal pleiotropy in the analysis of CRP and overall EC, endometrioid endometrial cancer, or non-endometrioid cancers (P > .05). In the reverse analysis, our data demonstrated that EC exert no reverse effect on CRP levels. Our study suggested causal relationships between CRP and an elevated risk of EC and its subtypes, which contribute to the ongoing discourse on the role of inflammation, as indicated by CRP levels, in the etiology of EC and its variants.
关于C反应蛋白（CRP）水平与子宫内膜癌（EC）之间的关系，目前仍未达成共识。我们的研究旨在阐明CRP与EC之间的因果关系，以促进对这种复杂相互作用的理解。我们主要采用随机效应逆方差加权法。这种方法是我们分析的基础，并辅以另外三种技术，包括孟德尔随机化-埃格法、加权中位数法和加权众数法。我们还进行了一系列敏感性分析，以确认结果的稳定性和可靠性。采用逆方差加权法，我们的研究结果表明，对数转换后的CRP浓度（mg/L）每增加一个单位，总体EC风险相对增加9.7%（优势比[OR]=1.097，95%置信区间[CI]：0.996-1.208，P=0.061），子宫内膜样子宫内膜癌风险增加11%（OR=1.110，95%CI：1.000-1.231，P=0.049），非子宫内膜样癌风险增加25%（OR=1.250，95%CI：1.005-1.555，P=0.045）。敏感性分析未发现CRP与总体EC、子宫内膜样子宫内膜癌或非子宫内膜样癌分析中存在水平多效性的证据（P>0.05）。在反向分析中，我们的数据表明EC对CRP水平没有反向影响。我们的研究表明CRP与EC及其亚型风险升高之间存在因果关系，这有助于就CRP水平所表明的炎症在EC及其变体病因中的作用展开持续讨论。
